Will A Scrotoplasty Improve The Discomfort I Have From A Traumatic Scrotal Hernia?
Q: Dr. Eppley, I had a trauma to the scrotum and testicles secondary to an assault where an effort to “pop” the testicles through the scrotum occurred. This eventually resulted in the loss of one testicle and caused the posterior skin behind the scrotum to become very stretched out and thinned. Now the remaining testicle hangs low and slides out of the muscular part of the scrotum into the stretched out skin below the scrotum. This feels uncomfortable while sitting and especially while exercising even though I use supportive underwear. The discomfort and appearance reminds me of the assault and restoring things as much as possible would be a great help from this devastating and humiliating injury. In cold conditions when the muscular part of the scrotum contracts, the testicle is pushed into the stretched out area of skin towards my leg and feels uncomfortable. My hope is that if the stretched areas were tightened to keep the testicle in the muscular part of the scrotum, I would be much more comfortable. While I did not have a prosthetic testicle implanted when the more severely injured testicle could not be saved, I am not interested in a prosthetic testicle being added because comfort is a great concern and I feel with one testicle my prospects for comfort is greater since a certain amount of chronic discomfort exists; nevertheless, I would like some of the extra scrotum cleaned up and made to look more tidy. I am not concerned about having large and impressive looking scrotum and testicles, but really want to be comfortable and would prefer to have a smaller, higher positioning of the remaining testicle.
A: Thank you for your inquiry and sending your pictures. What you appear to have is disruption of the enveloping Dartos fascia/cremasteric muscle which allows the remaining testicle to prolapse into the enlarged and thinned skin sac under certain conditions. In essence you have a scrotal hernia. You are correct is that excision of the stretched out skin/tissues with a reinforced closure (aka scrotoplasty) will very likely help with the discomfort as well as its appearance.
Dr. Barry Eppley